Symptoms of coccydynia

The symptoms described vary:

Pain during or after sitting, the level of pain depending on how long you sit. This is the main problem caused by coccydynia. How painful it is also depends on the design of the chair and the padding. The increased pain and sensitivity caused by having to sit for a long period may continue for days afterwards.

Acute pain while moving from sitting to standing. This symptom is particularly interesting, as Dr Maigne found that all of the patients he tested who had this particular symptom had a coccyx that partially dislocated or moved abnormally when the patient sat down. This was reported in the medical paper, Treatment strategies for coccydynia. The reason for the pain is thought to be that there are various muscles you use for rising which are also attached to the coccyx. When you go to rise, the muscles pull on the coccyx, pulling it out of position if the joint is damaged. Note - Sally Cowell wrote: To avoid this pain, try sitting leaning forward a bit and hollow your back a lot. This got rid of pain going from sitting to standing for me.

Pain caused by sitting on a soft, but not a hard surface. As I understand it, this is usually happens when the joint between the sacrum and coccyx is unstable, so that the coccyx can be pushed out of place when you put pressure on it by sitting or lying. When you sit on a hard surface, most of your weight is taken on your 'sit-bones' (ischial tuberosities), the hard bits at the bottom of your pelvis. But when you sit on a soft surface, the foam rubber pushes up between the bones, increasing the pressure inside you and pushing the coccyx out of place.

Deep ache around the coccyx

Sensitivity to finger pressure on the tip or edges of the coccyx

Shooting pains down the leg

Like sitting on a marble that moves around

Like sitting on a knife

Like being impaled on a garden cane, with or without chilli peppers

Pain during bowel movements, and sometimes before

Pain during sexual intercourse, either in men or women. One woman reported that the doctors didn't take her pain seriously, even though she could not sit, until she told them that the pain meant that she was unable to have intercourse with her husband. They then believed that intervention was essential.

If the pain was caused by trauma, then there may be other parts of the body damaged as well. If this damage includes the sacrum, hips or legs, it may be very difficult to sort out what is causing the most pain. An injection of local anesthetic to the coccyx area helps to find out how much of the pain is caused by the coccyx.

Secondary symptoms

If the pain persists for a long time, it is common for people to get secondary symptoms, such as:

Painful feet, from standing too much. One particular problem that can develop is plantar fasciitis. Plantar means the foot, and fasciitis is inflammation of the fascia, or fibrous tissue enclosing and connecting muscles. It is a common problem with people who work standing up, particularly if they are over 40 and/or overweight. This condition is sometimes called heel spurs. There is a good site with information on plantar fasciitis.

Exhaustion, depression, lack of sleep. It is pretty obvious why you get these symptoms when you are in pain. Unfortunately, some doctors will focus on these problems and ignore the pain that is causing them. You need to make sure they focus on the source of the pain. Many coccyx pain sufferers find that some people, including some doctors, refuse to believe that they are in pain, saying that they imagine it because they are depressed. This is a desperate situation to be in - suffering pain, but not getting treatment for it because you are not believed. If this happens, it's not much use arguing with the doctor. Its time to find a new one.

Painful back, from sitting in awkward positions to relieve the pressure on the coccyx. If the back pains were caused by sitting badly, and didn't start before the coccyx pain, then manual treatments such as physiotherapy, osteopathy and chiropractic will often help.

Other aches and pains around the body. Pain in one region of the body can lead to hypersensitivity of another region due to crosstalk between the nerve fibres. In the case of coccyx pain, the whole area of the buttocks can become hypersensitive because of this effect. This, of course, makes sitting even more uncomfortable, and chairs and sitting positions which were initially OK can become uncomfortable. Hips may become painful if you are lying on them most of the time.